Insurance coverage

Insurance Coverage

Prior to admission you should advise your insurance company of your admission to gain pre-authorization and to know if the proposed treatment is covered by your policy. You should be aware that this does not necessarily ensure full payment of your charges by your health plan. We recommend that you liaise closely with your insurance company throughout your course of treatments.

Types of Insurance Coverage:
  • Full coverage: Many of the local Insurance Providers provide full medical coverage. However, even though you think you may have full coverage, there may be exceptions and regulations that you may not be aware of. It is your responsibility to inquire and discuss possible exceptions with your insurance provider. If your insurance company determines that they will not pay the bill, or only partially pay the bill, you will become responsible for the outstanding balance.
  • Partial coverage: Some insurance providers only pay 80% of your medical bills and you are responsible for the balance of 20%. In this case when you are registering, you will be requested to make a deposit against your portion of the estimated charges.
  • Foreign insurance coverage: In cases where your insurance provider is not locally based, such as in the USA, Canada, the Netherlands or other Caribbean islands, you may be expected to pay your bill and seek reimbursement directly with your insurance provider.
  • No insurance coverage: If you do not have insurance you will be expected to make a deposit based on the estimated total charges that you will incur for the services you will be receiving in our facility. After your medical services are provided and you are to be discharged, SMMC produces a billing statement. You will be expected to settle the bill upon discharge.
If your insurance is in order, the hospital will invoice the insurance company directly. However, if you receive any invoices from your consultants after discharge, you will need to forward these to your insurance company for payment.

Please note that take home medicines and physiotherapy aids are not covered by private medical insurance and you will therefore be presented with a bill where applicable.
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